Attendant at Nursing Home Refuses CPR

[quote]gregron wrote:
Couple things. The woman was not a DNR. She was a full code.

Secondly, the woman who was refusing to do CPR was an RN (that’s what they said on the news last night)

The companies policy is to call 911 and stand by with the patient. Without a doubt this is to avoid a lawsuit. The “good sameritan law” does not apply to people who are medically trained, which all the staff members would be (CPR/AED at a minimum) If the attempt to render aid and fail they would be opening themselves and the company up for a potentially huge law suit.

It’s a crummy situation but that’s how it goes. The patients family also said they didn’t have a problem with how it went down and that they knew the SNF’s policies before sending her there.[/quote]

I have never understood these type of policies. Terms like nonfeasance and misfeasance come to mind when I hear about people who work in the healthcare field, are medically trained, and fail to render aide. One would think that they, either individually or the company itself, would be even more at risk for civil litigation if they are trained to do the task and they fail or flat out refuse to do so.

Broken ribs mend. Lack of blood circulating o2 to the brain is fatal. Breaking a few ribs to keep life sustaining blood flowing until advanced care can be given is an acceptable risk in my book. This is common sense.

I work in public safety and am occasionally called to a doctor’s office or facility where basic healthcare / aide is given. I always shake my head in wonder as I am performing CPR as a medical first responder while a nurse or physician’s assistant, with significantly more medical training than I, watch on. I don’t get it.

^^liability man. It’s messed up but no one wants to get sued.

I get that…but still not right. And like I said, using their same f ed up logic, they still could open themselves up to civil litigation for failing to act when trained to do so. It is negligence on their part as far as I am concerned.

[quote]gregron wrote:
^^liability man. It’s messed up but no one wants to get sued. [/quote]

This…my friend is a lifeflight medic, and we were skiing and somebody had a heart attack on the lift…he had to keep giving CPR until the EMT’s showed up, an HOUR later. Once you start, you cannot stop.

[quote]UtahLama wrote:

[quote]gregron wrote:
^^liability man. It’s messed up but no one wants to get sued. [/quote]

This…my friend is a lifeflight medic, and we were skiing and somebody had a heart attack on the lift…he had to keep giving CPR until the EMT’s showed up, an HOUR later. Once you start, you cannot stop.[/quote]

Legislation is different in different places. As I understand it, where I live you cannot stop CPR until the person shows signs of life (unlikely), until a higher level of care arrives or until an emerging hazard makes it unsafe for you to continue. In other words you, the first aid provider, cannot pronounce death however unlikely survival has become.

However, after 2 minutes of sustained CPR you are permitted and in fact expected to enlist help from someone else if possible. If no one present is trained in CPR you can train someone on the spot in compression only CPR so they can relieve you. This is based on research that shows that after 2 minutes of sustained CPR your compressions will likely be becoming ineffective due to fatigue (obviously this will vary from person to person).

None of this has anything to do with this story, just putting it out there.

On point, when fear of liability prevents people from trying to help each other, that’s messed up. I realize it’s the world we made for ourselves, but it’s still messed up, obviously.

[quote]DoubleDuce wrote:

[quote]Rhino Jockey wrote:
A lot of patients in those types of homes have DNR orders. If the facility only had DNR patients such as some hospice facilities, I could see them withholding CPR but even with DNR patients, you can still give them oxygen and make them comfortable. You just dont do all the other stuff that goes along with a medical emergency of this sort such as intubation, IVs, medications, compressions, etc…

Not enough info was given to really get a clear picture.[/quote]

Oxygen is a considered a drug, at least in Tennessee. I don’t know if you can give it to a DNR patient.[/quote]

I work in an Emergency Room down here in Florida and we give oxygen via nasal cannula or non-rebreather to most of our DNR patients.

^^once you start CPR you cannot stop unless those situations you listed occur OR you become too exhausted to continue.

Chest compressions for an hour straight? No way man lol

[quote]clinton131 wrote:
I get that…but still not right. And like I said, using their same f ed up logic, they still could open themselves up to civil litigation for failing to act when trained to do so. It is negligence on their part as far as I am concerned. [/quote]
Its not right, however it is the society we are in today, the sharks go after the deeper pockets, so in the situation you outlined the provider is now at a risk of losing everything.

[quote]gregron wrote:
^^once you start CPR you cannot stop unless those situations you listed occur OR you become too exhausted to continue.

Chest compressions for an hour straight? No way man lol[/quote]
I have done it Greg, back when I was in the ER days, an hour and a half was my longest code, going back and forth with chest compressions and bagging.

most folks have no concept of how violent full code is, particularly in the old and dying.

crazy how some folks, w/in the medical profession, are wimps, afraid, dodge this type of conversation. fucking oncologists, for example, who skirt around the fact the patient is dying, passing the buck on speaking w/ family members about wishes and action plans towards end of life decision making.

the family decided to place her there knowing the policy. sounds like the nurse acted in accordance w/ policy. waivers from potential suits thereafter the rib cracking, internal bleeding, and likely death regardless, this might make for a more pro-active death camp for grandma.

it’s not all Grey’s anatomy folks.

It’s true more details are needed. However, posters going on about liability and saying “oh well, that’s just the world we live in” doesn’t cut it IMO. If she was not a DNR then the response is not acceptable. Apparently the family (and hopefully Grandma) were aware of the policy, so nothing will come of it.

I’m not a medical professional, I’m LEO, so I know a little bit about liability. I’ve performed CPR, felt the sternum and ribs break. I’ve moved seriously injured people with obvious spinal injuries to prevent them from burning to death. Am I opening myself and my department up to potential lawsuits? Without a doubt.

I have colleagues who have attracted lawsuits for saving a drowning person or not been covered by their insurance for injuries sustained in the line of duty because it was not an “approved or routine” part of the job. In other words, penalised for going the extra mile to save a life.

At the end of the day it doesn’t matter. I don’t understand how people can sleep at night after making no attempt to help a dying person because or “company policy” or “liability issues”.

And BTW, this is not the WORLD we live in, it’s America. This shit doesn’t happen in most other countries. The UK is getting close, but that’s the least of their worries.

[quote]KAS wrote:
It’s true more details are needed. However, posters going on about liability and saying “oh well, that’s just the world we live in” doesn’t cut it IMO. If she was not a DNR then the response is not acceptable. Apparently the family (and hopefully Grandma) were aware of the policy, so nothing will come of it.

I’m not a medical professional, I’m LEO, so I know a little bit about liability. I’ve performed CPR, felt the sternum and ribs break. I’ve moved seriously injured people with obvious spinal injuries to prevent them from burning to death. Am I opening myself and my department up to potential lawsuits? Without a doubt.

I have colleagues who have attracted lawsuits for saving a drowning person or not been covered by their insurance for injuries sustained in the line of duty because it was not an “approved or routine” part of the job. In other words, penalised for going the extra mile to save a life.

At the end of the day it doesn’t matter. I don’t understand how people can sleep at night after making no attempt to help a dying person because or “company policy” or “liability issues”.

And BTW, this is not the WORLD we live in, it’s America. This shit doesn’t happen in most other countries. The UK is getting close, but that’s the least of their worries. [/quote]

America’s world…we’re just livin in it.

[quote]KAS wrote:
It’s true more details are needed. However, posters going on about liability and saying “oh well, that’s just the world we live in” doesn’t cut it IMO. If she was not a DNR then the response is not acceptable. Apparently the family (and hopefully Grandma) were aware of the policy, so nothing will come of it.

I’m not a medical professional, I’m LEO, so I know a little bit about liability. I’ve performed CPR, felt the sternum and ribs break. I’ve moved seriously injured people with obvious spinal injuries to prevent them from burning to death. Am I opening myself and my department up to potential lawsuits? Without a doubt.

I have colleagues who have attracted lawsuits for saving a drowning person or not been covered by their insurance for injuries sustained in the line of duty because it was not an “approved or routine” part of the job. In other words, penalised for going the extra mile to save a life.

At the end of the day it doesn’t matter. I don’t understand how people can sleep at night after making no attempt to help a dying person because or “company policy” or “liability issues”.

And BTW, this is not the WORLD we live in, it’s America. This shit doesn’t happen in most other countries. The UK is getting close, but that’s the least of their worries. [/quote]

This…I can’t agree more. If you are in the business of helping people then do it.

I have been named in a suit along with my department. It was deemed as a frivolous lawsuit by the City attorney representing the department, yet they still paid out on it. Why? because it was cheaper to do so then paying the attorney in the end to defend the city. This practice is all too common and is a major part of the problem.

[quote]Derek542 wrote:

[quote]gregron wrote:
^^once you start CPR you cannot stop unless those situations you listed occur OR you become too exhausted to continue.

Chest compressions for an hour straight? No way man lol[/quote]
I have done it Greg, back when I was in the ER days, an hour and a half was my longest code, going back and forth with chest compressions and bagging. [/quote]

If you have a partner to switch off with then you could do it but going solo for an hour+ of compressions?

Wheeeeeeeeeew!!!

Doing compressions straight for 6-8 minutes is tiring lol

[quote]clinton131 wrote:

[quote]KAS wrote:
It’s true more details are needed. However, posters going on about liability and saying “oh well, that’s just the world we live in” doesn’t cut it IMO. If she was not a DNR then the response is not acceptable. Apparently the family (and hopefully Grandma) were aware of the policy, so nothing will come of it.

I’m not a medical professional, I’m LEO, so I know a little bit about liability. I’ve performed CPR, felt the sternum and ribs break. I’ve moved seriously injured people with obvious spinal injuries to prevent them from burning to death. Am I opening myself and my department up to potential lawsuits? Without a doubt.

I have colleagues who have attracted lawsuits for saving a drowning person or not been covered by their insurance for injuries sustained in the line of duty because it was not an “approved or routine” part of the job. In other words, penalised for going the extra mile to save a life.

At the end of the day it doesn’t matter. I don’t understand how people can sleep at night after making no attempt to help a dying person because or “company policy” or “liability issues”.

And BTW, this is not the WORLD we live in, it’s America. This shit doesn’t happen in most other countries. The UK is getting close, but that’s the least of their worries. [/quote]

This…I can’t agree more. If you are in the business of helping people then do it.

I have been named in a suit along with my department. It was deemed as a frivolous lawsuit by the City attorney representing the department, yet they still paid out on it. Why? because it was cheaper to do so then paying the attorney in the end to defend the city. This practice is all too common and is a major part of the problem. [/quote]

+1.

When we start making our decisions based primarily on fear of external scrutiny, consequences, lawsuits, policies etc as opposed to what’s right, we are well and truly fucked.

CYA is important in this day and age, denying that is just naive. However it can’t become the be all end all.

[quote]gregron wrote:

[quote]Derek542 wrote:

[quote]gregron wrote:
^^once you start CPR you cannot stop unless those situations you listed occur OR you become too exhausted to continue.

Chest compressions for an hour straight? No way man lol[/quote]
I have done it Greg, back when I was in the ER days, an hour and a half was my longest code, going back and forth with chest compressions and bagging. [/quote]

If you have a partner to switch off with then you could do it but going solo for an hour+ of compressions?

Wheeeeeeeeeew!!!

Doing compressions straight for 6-8 minutes is tiring lol[/quote]

You’re a wimp gregron. I once did compressions for 181 minutes on a squirrel I found passed out in the woods. It turns out my efforts were useless though because its airway was obstructed. It was nuts.

[quote]super saiyan wrote:

[quote]gregron wrote:

[quote]Derek542 wrote:

[quote]gregron wrote:
^^once you start CPR you cannot stop unless those situations you listed occur OR you become too exhausted to continue.

Chest compressions for an hour straight? No way man lol[/quote]
I have done it Greg, back when I was in the ER days, an hour and a half was my longest code, going back and forth with chest compressions and bagging. [/quote]

If you have a partner to switch off with then you could do it but going solo for an hour+ of compressions?

Wheeeeeeeeeew!!!

Doing compressions straight for 6-8 minutes is tiring lol[/quote]

You’re a wimp gregron. I once did compressions for 181 minutes on a squirrel I found passed out in the woods. It turns out my efforts were useless though because its airway was obstructed. It was nuts.[/quote]

Hahahaha

The funny thing about the whole situation is that everyone detests the moral implications of this nurse’s decision but doesn’t really care “that much” about the fact one more old person finally met their maker. What’s better is the patient in question was admitted to the facility with their family’s full or at least adequate knowledge about the facility’s policy, which would have been legally required to be presented before any documentation was signed for the patient’s admittance.

If anyone killed that lady it was her family.

The only point I will agree with you sympathisers is on the reprehensible nature of the litigation-nation label on the U.S. The whole system needs to be changed if you don’t want incidents like this in the future.